Individual provider Active NPI

Camille Ellimac-Raheem, LPC

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1558092767
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.019291 Issued in IL
Practice address
900 E Diehl Rd Ste 101
Naperville, IL 60563-2394
Phone
(630) 428-7890
NPI assigned
Jun 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.019291 IL Primary
Mental Health Counselor 101YM0800X 178.019291 IL

Addresses

Primary practice location

900 E Diehl Rd Ste 101
Naperville, IL 60563-2394

Mailing address

PO Box 4911
Naperville, IL 60567-4911
Phone (630) 877-8602

Other practice location 1

1325 Remington Rd
Schaumburg, IL 60173-4834
Phone (847) 654-9996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178.019291ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Mental Health CurrentSince Sep 17, 2023 Accepting new patients

Locations

900 E Diehl Rd
Ste 101
Naperville, IL 60563
Phone (630) 328-0134

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1558092767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4911",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605674911",
            "telephone_number": "630-877-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E DIEHL RD STE 101",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632394",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 Remington Rd",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734834",
            "country_code": "US",
            "telephone_number": "847-654-9996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIMAC-RAHEEM",
        "first_name": "CAMILLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-19",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.019291",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.019291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.